Transgender & PMDD

Transgender individuals with PMDD often do not receive the support that they need and deserve. At IAPMD, we are committed to providing Peer Support, education, and advocacy for all individuals living with PMDD/PME regardless of gender identity. Similar to the experience of cisgender women, transgender individuals with PMDD sometimes experience an increase in the severity of feelings of depression, anxiety, rage, and suicidal ideation when using synthetic hormones and/or gonadotropin-releasing hormone agonist (GnRH agonist or GnRH–A).

According to published guidelines from the Center of Excellence for Transgender Health, there is no clear evidence that testosterone therapy is directly associated with the onset of or worsening of mental health conditions, including PMDD. In fact, it has been found that transgender men experience improvements in social functioning and reduced anxiety and depression once testosterone therapy is begun.

It is not well understood if transgender women are able to develop PMDD, although many do report PMS like symptoms when using hormone therapy. "Chemically induced PMDD" is quite plausible and further research is needed.

It is important to not attribute all symptoms of depression, anxiety, rage, or suicidal ideation to HRT, testosterone therapy, or being transgender. Tracking symptoms with a symptom tracker for two or more menstrual cycles can indicate PMDD or premenstrual exacerbation of an underlying disorder (PME). Fortunately, many trans individuals do report a lessening of symptoms from transition-related healthcare including HRT and gender-confirming surgery.

Suicidality

Suicide attempts among trans men are slightly higher than trans women at 46 percent to 42 percent respectively. The overall rate of transgender suicide is 41 percent, which vastly exceeds the 4.6 percent of the overall U.S. population who report a suicide attempt in their lifetime.

If you identify as transgender and are experiencing suicidal ideation or a mental health crisis, please reach out for support by contacting Trans Lifeline at: